DESCRIPTION: Otitis media (OMM) is one of the most common causes of pediatric visits, accounting for approximately 1/3 of all illness visits. Acute otitis media (inflammation of the middle ear) occurs in 60% of infants during the first year of life and 85% by age 3. Approximately 17% of children suffer recurrent otitis media during the first year of life. Following acute otitis media, middle ear fluid effusions can persist for weeks to months. Approximately 40% of children with middle ear effusions have middle to moderate hearing loss for the duration of the effusion, and several studies have found evidence for impaired speech and language development among children with prolonged middle ear effusion. Since antibiotic use has become widespread, concern has emerged regarding antibiotic resistant S. Pneumoniae strains and other bacteria. Children with recurrent otitis media commonly receive prophylactic antibiotic therapy or surgical insertion of tubes to prevent accumulation of middle ear effusion. The prevalence of pediatric use of alternative and complementary medical approaches for prevention of otitis media has not been widely quantified. A survey of parents of children visiting a general outpatient clinic at a University Hospital in Quebec revealed that 1% of children had previously consulted an alternative medicine practitioners. Fifty-one percent of these visits were for respiratory, ear, nose, and throat problems. The predominant visits were chiropractic, but other visits were also described. Of potential herbal therapies, only limited data are available. However, a variety of approaches have been described including eliminating potential dietary allergens, reducing simple carbohydrates, using nutritional supplements such as beta-carotene, vitamin C, zinc, flavinoids, and primrose oil, and botanical medicines including echinacea, golden seal, and licorice. However, none of these has been subjected to controlled clinical trial.